NURS 3365 FINAL EXAM 2026 ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔Pharmacodynamics. - ✔✔What the drug does to the body. MOA. Binds to the
receptor.
✔✔Why the caution with narrow therapeutic index drugs? - ✔✔easy to over dose
✔✔Allergy - ✔✔Requires the involvement of the immune system
May be mild
May be severe- anaphylaxis- / angioedema
IGE
✔✔Class Effect - ✔✔toxicity known to all members of a drug class
✔✔Pharmacogenetics-related reactions - ✔✔idiosyncractic
unpredictable
polymorphism
✔✔The Big 3- proactivity - ✔✔What Class of Drug is this? What is the Prototype drug?
Indications and contradictions
MOA
✔✔The Big 3- Communication - ✔✔ISBAR= Identification, Situation, Background,
Assessment, Recommendation/request for order
✔✔The big 3- Patient teaching - ✔✔Teaching pation meds and side effects and what to
look for toxicity
✔✔Muscarinic versus adrenergic receptors - ✔✔muscurinic- ACH
Adrenergic- NE
✔✔Cholinergic direct agonists - ✔✔Work on muscarinic receptor increase acetylcholine.
BETHANECHOL
✔✔cholinergic indirect agonist - ✔✔inhibit acetylcholinesterase- increase acetylcholine
available to bind the receptor (also called anti-cholinesterase drugs) PHYSOSTIGMINE
✔✔Indirect acting cholinergic agonist for Alzheimer - ✔✔donazepil (Aricept)
✔✔What could cause cholinergic toxicity? - ✔✔Mushrooms, Too much cholinergic
drugs, insecticide, nerve gas.
✔✔cholinergic toxicity mnemonic - ✔✔DUMBELLS
, ✔✔What is the antidote for cholinergic toxicity? - ✔✔Anticholinergic drugs. EX Atropine.
✔✔Anticholinergic toxicity antidote - ✔✔physostigmine- an antichlinesterase drug-
therefore it is an indirectly acting cholinergic agonist (look at the animation in
Blackboard). Given if the patient is exhibiting CNS effects of the anticholinergic toxicity.
No, bethanechol won't work.
✔✔Anticholinergic mnemonic - ✔✔Red as a beet, = flushed skin tones;
dry as a bone= skin and mucus membranes are dry;
hot as a hare= skin is warm ,
blind as a bat= dilated pupils;
mad as a hatter= CNS effects -confusion
Full as a flask= urinary retention
✔✔Anticholinergic - ✔✔Competatively binds to the muscurinic receptors. ATROPINE
✔✔Other drug classes that have anticholinergic side effects - ✔✔i. Antihistamines (first
generations) diphenhydramine (Benadryl)
ii. Antipsychotics (many)
iii. Older antidepressants amitriptyline (Elavil)
iv. Incontinence medications oxybutinin (Detrol)
v. Parkinson's drug benztaropine (Cogentin)
✔✔Epinephrine - ✔✔Stimulates beta 1, (think heart rate and contractility) beta 2, (think
bronchodilation) and alpha 1 receptors (think vasoconstriction
✔✔OTC nasal and oral decongestants contain alpha 1 agonists. - ✔✔Oral
decongestants pseudoephredrine /pheylephrine (sympathomimetic). Cause systemic
effects anxiety irritability and shakiness.
Nasal sprays like Afrin exert local effects.
✔✔LABAs (long acting bronchodilators) - ✔✔beta 2 agonists
✔✔Bronchodilators (SABAs short acting bronchodilators) - ✔✔beta 2 agonists
✔✔Epinephrine administration - ✔✔IV versus IM/subcutaneous
✔✔Epinephrine uses - ✔✔Cardiac Arrest and Anaphylaxis
✔✔What is the difference between cardio-selective (Atenalol)-non-cardio- selective
(Propranolol) beta blockers? - ✔✔Cardio selective is only BETA 1 and non cardio
selective is beta 1& 2
ANSWERS RATED A+
✔✔Pharmacodynamics. - ✔✔What the drug does to the body. MOA. Binds to the
receptor.
✔✔Why the caution with narrow therapeutic index drugs? - ✔✔easy to over dose
✔✔Allergy - ✔✔Requires the involvement of the immune system
May be mild
May be severe- anaphylaxis- / angioedema
IGE
✔✔Class Effect - ✔✔toxicity known to all members of a drug class
✔✔Pharmacogenetics-related reactions - ✔✔idiosyncractic
unpredictable
polymorphism
✔✔The Big 3- proactivity - ✔✔What Class of Drug is this? What is the Prototype drug?
Indications and contradictions
MOA
✔✔The Big 3- Communication - ✔✔ISBAR= Identification, Situation, Background,
Assessment, Recommendation/request for order
✔✔The big 3- Patient teaching - ✔✔Teaching pation meds and side effects and what to
look for toxicity
✔✔Muscarinic versus adrenergic receptors - ✔✔muscurinic- ACH
Adrenergic- NE
✔✔Cholinergic direct agonists - ✔✔Work on muscarinic receptor increase acetylcholine.
BETHANECHOL
✔✔cholinergic indirect agonist - ✔✔inhibit acetylcholinesterase- increase acetylcholine
available to bind the receptor (also called anti-cholinesterase drugs) PHYSOSTIGMINE
✔✔Indirect acting cholinergic agonist for Alzheimer - ✔✔donazepil (Aricept)
✔✔What could cause cholinergic toxicity? - ✔✔Mushrooms, Too much cholinergic
drugs, insecticide, nerve gas.
✔✔cholinergic toxicity mnemonic - ✔✔DUMBELLS
, ✔✔What is the antidote for cholinergic toxicity? - ✔✔Anticholinergic drugs. EX Atropine.
✔✔Anticholinergic toxicity antidote - ✔✔physostigmine- an antichlinesterase drug-
therefore it is an indirectly acting cholinergic agonist (look at the animation in
Blackboard). Given if the patient is exhibiting CNS effects of the anticholinergic toxicity.
No, bethanechol won't work.
✔✔Anticholinergic mnemonic - ✔✔Red as a beet, = flushed skin tones;
dry as a bone= skin and mucus membranes are dry;
hot as a hare= skin is warm ,
blind as a bat= dilated pupils;
mad as a hatter= CNS effects -confusion
Full as a flask= urinary retention
✔✔Anticholinergic - ✔✔Competatively binds to the muscurinic receptors. ATROPINE
✔✔Other drug classes that have anticholinergic side effects - ✔✔i. Antihistamines (first
generations) diphenhydramine (Benadryl)
ii. Antipsychotics (many)
iii. Older antidepressants amitriptyline (Elavil)
iv. Incontinence medications oxybutinin (Detrol)
v. Parkinson's drug benztaropine (Cogentin)
✔✔Epinephrine - ✔✔Stimulates beta 1, (think heart rate and contractility) beta 2, (think
bronchodilation) and alpha 1 receptors (think vasoconstriction
✔✔OTC nasal and oral decongestants contain alpha 1 agonists. - ✔✔Oral
decongestants pseudoephredrine /pheylephrine (sympathomimetic). Cause systemic
effects anxiety irritability and shakiness.
Nasal sprays like Afrin exert local effects.
✔✔LABAs (long acting bronchodilators) - ✔✔beta 2 agonists
✔✔Bronchodilators (SABAs short acting bronchodilators) - ✔✔beta 2 agonists
✔✔Epinephrine administration - ✔✔IV versus IM/subcutaneous
✔✔Epinephrine uses - ✔✔Cardiac Arrest and Anaphylaxis
✔✔What is the difference between cardio-selective (Atenalol)-non-cardio- selective
(Propranolol) beta blockers? - ✔✔Cardio selective is only BETA 1 and non cardio
selective is beta 1& 2
